In wake of mass shootings, health experts warn of mental toll

The shooting incident that left 19 students dead last week may have happened 1,300 miles away in Texas, but local mental health experts said feelings of fear and helplessness should be expected locally.

Nineteen children and two teachers were gunned down at Robb Elementary School in Uvalde, Texas last week. Jeremiah Schumm, an associate professor at Wright State University’s School of Professional Psychology, said Texas is far away but the feelings of anxiety here are very real.

“It’s just such a horrific type of trauma that is not supposed to happen,” Schumm said. “We have this idea in our minds that children are not supposed to be killed, parents are not supposed to outlive their children. So that sort of expectation of how life should happen makes traumas like this especially difficult to understand and to accept when they happen.”

On Tuesday, 18-year-old Salvador Ramos shot his 66-year-old grandmother in the face at their Uvalde home, stole her truck and headed for the school. He opened fire on the students and their teachers around 11:30 a.m. with an AR-15-style rifle. Texas Gov. Greg Abbott said during a news conference Wednesday the gunman posted on Facebook shortly before the shooting: “I’m going to shoot an elementary school.”

Dr. Paul Crosby, president and CEO of the Lindner Center of Hope in Warren County, said both strong feelings or even a “deadened response” are expected.

“It’s completely normal, conversely it also can be normal to have a deadened response to it, to have that reaction that, ‘Hey that’s far away, it’s a different community, that sort of stuff happens there, not here.’ That’s our brains protecting us from something that’s incomprehensible and it’s something we can’t have a lot of control over,” Crosby said.

“Anxiety thrives on uncertainty and lack of control and this has both elements of that. While it happened far away in a different town, I think a lot people can identify with having young children who are supposed to be safely learning in the elementary school. I think it hits close to home for a lot of people because of that.”

It’s even closer to home with the mass shootings in the past few years, first in 2016 when a 15-year-old opened fire in the cafeteria at Madison Jr./Sr. High School and wounded three fellow students in Butler County. More recently, the community was reeling after Connor Betts slayed nine when he opened fire in the Oregon District of Dayton on Aug. 4, 2019.

Explaining violence to children

Carrie Kunzelman, a supervisor for the mental health outpatient program with Community First Solutions in Butler County, said parents should be careful how they are reacting to these mass murders because their kids can sense something is wrong if they don’t already know about it, which is unlikely.

“While the kids maybe didn’t hear about it, they know that their parents are reacting differently than they normally do. So even though it happened hundreds of miles away it still impacts the kids,” Kunzelman said.

Crosby said many parents’ first instinct is to shield their kids from events like this, but that that doesn’t help them because “people’s imaginations can kind of go from there.” Talk to your kids, he recommends, but “keep it to simple, concrete explanations.”

“Don’t be afraid to talk about it and say something really bad happened. It’s not only OK, but actually really important for parents to display emotions around things like this. Kids need to see that there’s a language and an expression for the feelings that we’re having inside and that those are okay,” Crosby said.

“Being a parent is tough, and it’s hard to know what to do, so sometimes it can be reassuring to hear, ‘It’s okay to talk about it.’ You’re not going to keep your kid from hearing it, so go ahead and talk about it, because then you get to choose what to say and how they hear it. And also it’s OK to have some tears or to talk about how it makes you angry.”

Dr. Courtney Cinko, a child and adolescent psychiatrist and medical director of emergency psychiatry at Cincinnati Children’s, agreed parents need to talk to their kids about this and “parents need to be direct and honest” because their kids will know if they’re not.

She said parents should “center themselves” first, open the conversation with a statement about the shooting and ask them how they are feeling about it. Then they will instinctively know how to proceed, Cinko said.

“The kids that are really upset and scared, the first thing you do is validate that. You say it is scary, it’s confusing, it’s a horrible thing that happened, it shouldn’t have happened. But then the next step is to say, ‘We’re going to keep you safe, it is my job as your parent, as your caregiver to keep you safe,’” she said. “So you validate their feelings and then reassure them that this isn’t going to happen to them.

“Even if on the inside you’re thinking I don’t know that because you’re very anxious, don’t tell the kids that.”

How long can trauma persist?

If children are still experiencing anxiety, seem not like themselves or symptoms worsen after a few weeks, parents should ask their pediatrician if they should seek counseling, Cinko said. Many experts are reporting that children are fearful of going to school. Cinko said that feeling should wane.

“Kids are very resilient, and I think baring any more tragedies over the summer — we can’t be certain of any of this anymore — but I think most kids will be doing better and bounce back by the time school starts again,” she said. “They’ll have a lot of time to process it, digest it, they’ve had lots of months of safety under their belts to reassure them.”

People who experienced the mass shooting in Dayton, and the Madison Schools shooting could also be having their own difficulties with this tragedy, commonly known as post traumatic stress syndrome, or PTSD.

“There’s going to be some flashbacks and even some really intense memories that folks are going have,” said Julie Manuel, a licensed professional clinical counselor with Kettering Health. “Feeling some intense memories of what the aftermath felt like for them. They’re going to be kind of walking in their shoes, oh gosh I remember what that felt like and maybe feel sad and angry and feel helpless in the next couple days and weeks.”

If the symptoms persist, she said, they might want to seek help. Schumm said people might want to avoid dealing with their emotions but that is not a good strategy. Calling a mental health hotline is a good first step.

“Having good social support systems for those that start to develop symptoms and have symptoms that become impairing having good mental health treatment,” Schumm said. “What’s amazing about human beings and children included of course, is that people are surprisingly and amazingly resilient following trauma, even horrific trauma.”

Not all mass murderers are mentally ill

Ramos, the shooter was killed during the attack on Robb Elementary School, was a high school dropout who had no known criminal record or history of mental health problems, according to Texas officials. When mass shootings occur, the first thing people assume is the person is mentally ill, but experts say that is not always true.

According to, “Most people with mental illness are not violent and only 3%–5% of violent acts can be attributed to individuals living with a serious mental illness. In fact, people with severe mental illnesses are over 10 times more likely to be victims of violent crime than the general population.”

Manuel said she has been treating people with mental illness her entire career and violent tendencies are not the norm.

“There’s only about a handful of cases where I felt threatened or there was violence, or that the person committed some type of violence,” Manuel said. “Because oftentimes they don’t want to hurt other people, it has nothing to do with other people, it’s about themselves.”

Rhonda Benson, executive director for the Butler County chapter of the National Alliance on Mental Illness, said incidents like these increase the stigma around mental illness.

“Most of these crimes are committed by people who are not necessarily mentally ill — I mean horrendous crimes,” Benson said. “Television plays up mental illness and makes people think anyone who does these things has got to be mentally ill, but some of these folks are just as sane as you or me ... they’re just evil.”

In the half-hour before the school killings, Ramos posted to Facebook that he was going to shoot his grandmother, then that he had done so and that he was going to shoot up an unspecified elementary school, officials said.

Manuel said behaviors that should raise red flags include someone socially distancing themselves at school or work, failing grades or problems at home, a sense of hopelessness or helplessness, posting violent videos or quotes on social media or abnormal irritability. But she’s also not sure people would report this to anyone.

“I don’t know that people right now, in the way that our world has been going for several years, would reach out and say, ‘Hey, this is a red flag,’” Manuel said. “Because I think people are still anxious, depressed, feeling isolated from COVID and just really fearful of kind of what’s happening in the world.”

The Associated Press contributed to this article.

How to seek help

For people who are coping after a traumatic experience, a good first step is to call a local crisis hotline. Trained professionals are available around the clock to talk with you.

Butler County: Call 1-844-4CRISIS;

Montgomery County: Call 1-833-580-CALL (2255);

Warren and Clinton counties: 877.695.NEED (6333);

About the Author